Health & Welfare Plans Newsletter

August 10, 2016

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[Guidance Overview]

IRS Proposes Adjustments in Individual Mandate Reporting
"Although the guidance does not address the timing of the reports themselves, plan sponsors should keep in mind that the automatic extension for the reports under sections 6055 and 6056 of the Internal Revenue Code applied only to the reports filed earlier this year for coverage provided in 2015. For coverage provided in 2016, plan sponsors will need to gear up to issue statements to individuals by January 31, 2017, and to file reports with the IRS by February 28, 2017 (March 31, 2017, if filing electronically)."
Ballard Spahr LLP

[Advert.]

Register today for the Employee Benefits Symposium - Baltimore, Sept. 18-21

Sponsored by International Foundation of Employee Benefit Plans [IFEBP]

For over 35 years, the Symposium has been the must-attend event for thousands of corporate benefits professionals. No other benefits event can match the collection of timely, relevant topics presented by world-class speakers. Register now.


Soliciting Tax Identification Numbers for Section 6055 Reporting
"The first step of the TIN solicitation process is the initial request for an individual's TIN when the employer receives a substantially complete application for new coverage or to add an individual to existing coverage. Therefore, receipt of an employee's application would be considered the initial solicitation.... If the TIN is not initially received, then a second solicitation must be made no later than 75 days after the initial solicitation.... If the TIN is not received from the second solicitation then a third solicitation must be made by December 31 of the year following the initial solicitation."
Compliance Dashboard

Employers' Health Plan Cost Increases Will Be Far Lower Than ACA Premiums
"A majority of large employers expect the cost growth for their health care benefit to remain stable at 6 percent in 2017, but specialty drugs are the most-cited driver of cost increases ... Many employers expect to be able to hold cost growth at 5 percent by making changes to plan benefit designs. There's also a growing focus on streamlining delivery systems and tactics aimed at controlling drug costs."
Morning Consult

Unreasonable But Customary: Can You Read Your Benefits Booklet?
"Clear concise communication of your benefit plan is important. It contributes to employee satisfaction with the plan and helps avoid misunderstanding about coverage. As we move further and further into a world of brief, electronic communication, the traditional booklet holds little appeal for employees. At the same time, people are more reluctant to call a carrier and waste time on hold waiting for an answer to an obvious question -- after all, the benefit summary says orthotics are covered to a maximum of $500."
Xerox HR Insights

Provider Directory Data Accuracy in California Law's Crosshairs
"[California law] requires all health plans in the state to keep their provider directories online and up-to-date -- so much so that the bill requires a plan or insurer, at least weekly, to update its online provider directory, and at least quarterly, to update its printed provider directory.... By the end of July 2017, health plans' Web sites must be able to let visitors search by name, practice address, city, zip code, California license number, national provider identifier number, admitting privileges to an identified hospital. The main effort of the bill is focused on ambulatory and specialty care providers."
HealthLeaders Media

[Advert.]

Changes to Cafeteria Plans: What You Need to Know to Prepare

Sponsored by Lorman and BenefitsLink

September 21 webinar. Explores design choices available within the regulatory framework established by the IRS, and provides tools to ensure that cafeteria plan design, documentation and administration are in compliance with applicable requirements.


Double-Digit Premium Hikes Debunk California's 'Active Purchaser' Claim
"With some embarrassment, Covered California (the state's Obamacare exchange where people can purchase health coverage) has announced the average premium hike next year will be 13.2 percent. For many subscribers, the hike will be much greater ... California is one of only four states in which the Obamacare exchange has the statutory authority to act as an 'active purchaser,' substituting its own judgment about benefits consumers value for their own."
National Center for Policy Analysis [NCPA]

DOL Announces $1.1M to Study Paid Leave Programs
"The [DOL's] Women's Bureau [on August 9] awarded $1.1 million in grants to research and analyze how paid-leave programs can be developed and implemented across the country. The grants build on the Paid Leave Analysis Grant Program that, since 2014, has committed more than $3 million to 17 states and municipalities to support research and analysis on the implementation of paid family and medical-leave programs."
Employee Benefits Security Administration [EBSA], U.S. Department of Labor [DOL]

What We've Learned from the Paid Leave Grant Program
"Massachusetts, the District of Columbia and Montana studied the costs of implementing a paid family and medical leave program. What they found is that having a program can be affordable for workers and employers -- and perhaps even more affordable than not having one.... Rhode Island's findings highlight the importance of outreach even after paid leave legislation is passed. Continued research and analysis is critical as states, cities and municipalities consider different paid leave programs and funding mechanisms."
U.S. Department of Labor [DOL] Blog

Insurance Status Affects Outcomes for Patients With Cancer
"Patients with Medicaid or without insurance were more likely to be diagnosed at a later stage, received less-than-optimal treatment, and had shorter survival times.... Medicaid patients were less likely to receive surgical treatment [and] these same patients, as well as those without insurance, were less likely to receive adjuvant radiotherapy. Patients who were uninsured or had Medicaid are also more likely to present with larger tumors compared with patients with other insurance."
American Journal of Managed Care

[Opinion]

U.S. Chamber of Commerce Comment Letter to IRS on Expatriate Health Plans, Expected Benefits, and Limited Duration Insurance
"If finalized, these regulatory proposals would render an overly narrow and restrictive application of the flexibility that the EHCCA was designed to provide: the compliance deadline or effective date; the new regulatory definition of 'substantially all;' the new notice requirement for electronic furnishing of statements; the truncated term for short-term, limited duration insurance; and travel requirements for expatriates. The Chamber has discrete concerns regarding each of these sections and recommends substantive changes for these provisions in the Final Rule."
U.S. Chamber of Commerce

[Opinion]

It's Time for the Government to Play Hardball with Those Whining Obamacare Insurers
"What if [the government] conditioned participation in Medicaid and Medicare managed care on a certain minimum participation in the private exchanges? Alternatively, it could reinvent and restore the public option, whether by offering Medicare to all Americans under 65 or sponsoring its own public plans. These mechanisms might work because, given their lower premium rates, they might attract more low-use enrollees -- the elusive young and healthy cadres needed to help subsidize costlier and older members."
Michael Hiltzik, via Los Angeles Times

Benefits in General

Paper or Digital? Employee Benefit Enrollment Disconnect Could Hurt Employers
"[O]nly 38 percent of surveyed employers think that their employees want to use a computer to enroll, while more than a quarter believe that their employees still want to enroll through paper forms.... [But] 68 percent of employees want to enroll in their benefits online or electronically and only 16 percent want paper enrollment forms.... While 1 in 4 employers automatically re-enroll their employees annually in at least some benefits, less than 10 percent of employees prefer this automated process."
LIMRA

Executive Compensation and Nonqualified Plans

ISS 2017 Policy Survey Focuses on Executive Comp, Incentive Plan Design and Governance Issues
"Similar to last year's survey, this year's survey is relatively light volume-wise in the executive compensation arena, with only three main questions overall. However, say-on-pay-related policies could be in line for an important update if the survey topics ultimately spur changes. Also note that ISS does not always include all areas of potential change in the survey, so voting policy changes could go beyond the issues covered in the survey. Here's a look at those issues:"
Willis Towers Watson

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BenefitsLink Health & Welfare Plans Newsletter, ISSN no. 1536-9595. Copyright 2016 BenefitsLink.com, Inc. All materials contained in this newsletter are protected by United States copyright law and may not be reproduced, distributed, transmitted, displayed, published or broadcast without the prior written permission of BenefitsLink.com, Inc., or in the case of third party materials, the owner of that content. You may not alter or remove any trademark, copyright or other notice from copies of the content.

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